Cheryl Richards edited Treatment.md  about 8 years ago

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The issue of temporary DBS treatment was raised by a case study (Zeka, 2015). The patient started having simple motor tics at the age of 7 followed by vocal and complex motor tics two years later. The patient also had ADHD and learning difficulties. Thalamic DBS surgery was provided when he developed continuous motor and vocal tics that resulted in him leaving school at the age of 17. A year after surgery his YGTSS score had decreased by 58%. 3 years after the surgery the tic severity increased and the IPG was replaced resulting in improved tic severity again. When the patient was 23 it was noticed that the IPG was not operational and there had not been any increase in the patient's symptoms. After the device was left off for 2 years and the patient remained stable clinically, the decision was made to remove the device and the patient was still stable 8 months later.  This review compares compared  electrophysiological data obtained in nonhuman primate models of TS and Parkinson's disease \cite{26180116}. This paper focuses on identifying possible mechanisms to account for the reason why high-frequency GPi-DBS is effective for treating both a hyper- and a hypokinetic disorder. This article focuses on the possibility that excessive synchrony and pathological low-frequency oscillations (LFO) impairs activation in the motor regions that receive input from the basal ganglia. There is also some evidence synchronous oscillatory activity and excess LFO contribute to TS. DBS effectiveness is considered to occur because population-scale firing rates are maintained allowing proper encoding of desired movement. When used with Parkinson patients, DBS suppresses excess LFO in the GPE in addition to the GPI. GPI-DBS is theorized to suppress the phasic activations in the GPe and the phasic inhibitons in the GPi for TS patients. It is hypothesized that in both medical conditions aberrant output is minimized whiler the population-averaged firing rate is maintained.  | **Title** | **Comment** |  |:----------|:------------|